Oaks of Mid City Resident Council v. Sebelius

723 F.3d 581 (5th Cir. 2013) · United States Court of Appeals for the Fifth Circuit · July 17, 2013 · No. No. 12-30860

Summary

The Fifth Circuit reviewed a civil contempt order arising from a preliminary injunction concerning the termination of a nursing facility from the Medicare and Medicaid programs. The court held that the government complied with the injunction because it did not rely on the termination notice to take prohibited action while the injunction was in effect. The court vacated the contempt finding and reversed the district court's judgment.

Court
United States Court of Appeals for the Fifth Circuit
Writing for the Court
Patrick E. Higginbotham; King; Higginbotham; Clement
Jurisdiction
Federal
Decision date
July 17, 2013
Docket number
No. 12-30860
Procedural posture
The government appealed a district court order holding it in civil contempt for allegedly violating a preliminary injunction concerning Oaks's Medicare and Medicaid provider agreements.
Standard of review
The court reviewed the contempt order for abuse of discretion, respecting factual findings unless clearly erroneous. It reviewed the scope of the preliminary injunction de novo as a question of law.
Precedential value
Published precedential opinion of the United States Court of Appeals for the Fifth Circuit
Parties
Kathleen Sebelius, Secretary of the United States Department of Health and Human Services, Marilyn Tavenner, Acting Administrator of the Centers for Medicare and Medicaid Services v. Oaks of Mid City Resident Council, D & W Health Services, Incorporated, doing business as The Oaks of Mid City Nursing and Rehabilitation Center
Disposition
reversed

Topics

medicare medicaidnursing home liabilitycontemptinjunctionsstandard of review

Practice areas

Medicare and Medicaidadministrative lawcivil procedureinjunctionscivil contemptappellate procedure

Questions Presented

  1. Whether the government violated the preliminary injunction by failing to make full payments for services provided during the injunction period.
  2. Whether the government violated the preliminary injunction by discontinuing Oaks's access to the Medicare electronic billing system after the injunction expired.
  3. Whether the government violated the preliminary injunction by issuing a zero-dollar tentative adjustment on Oaks's 2010 cost report while the injunction was in effect.
  4. Whether the district court properly held the government in civil contempt.

Holdings

  1. The government complied with the injunction by maintaining the preexisting payment status quo; the injunction prohibited refusing payment on the basis of the termination notice but did not require full, nonpreliminary payment for services.
  2. The government did not violate the preliminary injunction by cutting off Oaks's electronic billing access after the injunction was no longer in force.
  3. Oaks failed to prove that the fiscal intermediary's zero-dollar tentative adjustment violated the injunction.
  4. The district court abused its discretion by holding the government in civil contempt; the Fifth Circuit vacated the contempt finding and reversed the judgment.

Key quotations

Because the government did not rely on the Notice while the injunction was in effect, we REVERSE the contempt order. (slip op. at 2)
Thus, to violate the requirements of that injunction, the government had to act “on the basis of” the Notice—the Notice, in other words, must have caused the government to act differently than it would have otherwise. (slip op. at 6)
With the benefit of a clearer explanation than was given the able district court, we are persuaded that the government complied with the preliminary injunction while that injunction was in effect. (slip op. at 8)

Factual background

CMS determined that Oaks, a nursing facility, was no longer eligible to participate in the Medicare and Medicaid programs and issued a notice stating that its provider agreements would terminate on May 9, 2010. The district court enjoined the government from terminating the agreements or taking action on the basis of that notice, and the parties agreed that the preliminary injunction expired on June 16, 2011; a temporary restraining order expired on July 8, 2011. Oaks later alleged that the government failed to pay certain amounts, cut off its electronic billing access, and refused payment for services, leading the district court to enter a compensatory contempt order.

Procedural history

CMS notified Oaks that its Medicare and Medicaid agreements would terminate effective May 9, 2010. Oaks sued in the Middle District of Louisiana, and the district court preliminarily enjoined the government from terminating the agreements or taking action on the basis of the termination notice. After the injunction and a later temporary restraining order expired, Oaks sought contempt sanctions, and the district court ordered the government to reimburse Oaks $704,728.18. The Fifth Circuit vacated the contempt finding and reversed the district court's judgment.

Remand instructions

The finding of contempt was vacated and the district court's judgment was reversed; no further remand instructions were stated.

Court Document

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